He went on to predict, against everything I'd read or heard to that point, that I wouldn't even lose all of my hair. In the moment, that seemed like better news that an 85% survival rate. As to going through my chemotherapy, he said he'd be more than happy to treat me, but that medical science was such the boss of Hodgkin's, that he'd trust the treatment of his own daughter to just about any hospital in the country.
I'm always haunted by Christopher Hitchens' palpable essays from his final days succumbing to esophageal cancer, and it doesn't take much digging around online to break your heart on gut-wrenching stories of cancer. I started to feel like medical science should classify cancers in one of two major categories: "Extremely lethal" and "Don't worry, we got this."
In the end, I opted to undergo treatment at my neighborhood hospital because, to quote the MGH doctor, "There's something to be said about being able to go the hospital in your pajamas." MGH was an hour away without traffic. St. Joseph's was mere steps.
Before I knew it, it was time for my first day of chemo. I was introduced to the nurse who would be poisoning me for the day, and then was toured around what was a pretty nice facility. It consisted of a long comma-shaped room, the outer, arcing wall of which faced outside, allowing for a well-lighted area from the windows spaced regularly along it. The wall was lined with afghan-draped recliners, which then wrapped around at one end so that some of the recliners faced each across an empty space of floor. Each infusion station had its own IV stand and a curtain that could be pulled around for privacy, and there were TVs built into the walls and placed onto carts for whomever wanted them. There was also a kitchenette with free snacks and drinks, and a glass door led to a patio.
My personal cocktail of cure was referred to as ABVD, an acronym for the chemicals adriamycin, bleomycin, vinblastine, and dacarbazine. They dripped each one into my chest port separately over the course of about four hours. They also dripped steroids into me, both to ease the side effects and to make the treatment more effective. When each bag depleted, the IV machine would beep to let them know to hook up the next one.
In all, it wasn't too bad. It was a new experience, the nurses were great, my wife was there the whole time. Best of all, we were actively treating my cancer.
Twenty-four hours later, the sickness kicked in. "Wasn't too bad" stopped being a phrase I used for a long time. It was unrelievable agony. Nausea that wouldn't subside, aches that couldn't be soothed, weakness that wouldn't leave me. I'd been told chemotherapy affects different people in different ways, and that some are barely affected. I figured that since I was young-ish, it might be that way with me. No. I instantly aged three decades. When I could get off the couch I would shuffle around bent-over and covering a few inches a minute. Food helped a little, but I could only stand the sight of certain kinds and it took me a while to learn which ones. The other side of that is my intestines weren't working correctly, either. My body hated my chemical justice for its betrayal. I have no problem wishing a lot of things on a lot of people, but chemotherapy side effects is not one of them.
And then, four days later, just like that, the illness was gone.
From then on, I learned to live and plan around getting sick on schedule. Every other Monday was infusion day. Monday night I felt fine, but the steroids would keep me up all night, so that I'd often have to skip work the next day. Tuesday is when the sickness crept up on me like something repellant growing inside of me. Wednesday, I was increasingly sick but could persevere enough to go to work. Thursday, I was prostrate. But by Friday night I was better. The next week was my off-week, where I was completely normal, like I wasn't being killed by both a disease and a treatment.
Around the house, we started calling the condition Dexter's Disease since just a couple of months before my diagnosis we had watched Michael C. Hall -- the man who plays the titular serial killer in the Showtime series Dexter and who had contracted the same disease -- accept a Golden Globe for his performance wearing a black knit skullcap to cover a head bald from treatment.
With each round of treatment, the side effects grew more acute, their duration longer. I'd even experience them psychosomatically in my off weeks. For instance, there was a certain shade of red that always made me nauseated. That's because one of the chemicals in my chemo-binge, adriamycin, was red, and it would turn my urine a diluted shade of the color for the rest of the day. Even now, if I see that peculiar shade of red, I have chemo flashbacks.
The one place where my experience did gel with those aforementioned cancer motivational speakers and writers is that the only way I made it through was the support of family and friends. Next to my wife, probably the biggest help was somehow the company I worked for. They gave me ultimate flexibility in dealing with my cancer. It was a contract research organization -- the company to which pharmaceutical companies outsource their testing of new drugs. Testing, as in, on animals. At my interview, I was asked, "Are you okay with animal testing? Because that's what we do here." I hadn't known before the interview, and had never really given the topic much thought. However, I needed the job to move to New England, so I said yes.
Since I was in the marketing department, I didn't see the animals too much. It was mostly mice and rats, but there were other animals, beagles, macaques, guinea pigs, even saw a room full of sheep once. It bothered me, certainly. However, we created a lot of marketing collateral around how the research eased human suffering and saved lives. It became apparent to me quickly that either you're okay with animal testing, or you can never so much as take a Tylenol without being a hypocrite.
Now that I had cancer, I started paying more attention to the oncology "models," as the animals are called. I started noticing that chemicals in my ABVD regimen were being used to condition mouse models for research on how the drugs work, or to induce certain conditions that could then be studied -- the process that yielded the brew that was saving me. I wasn't so much writing marketing materials anymore, but autobiographical literature.
In between visits to the infusion room, I'd have to come in for other tests. Bloodwork, for instance. That was a constant. Staff always greeted you with a syringe. There were also lung tests and PET scans, the latter performed in a truck-trailer mobile unit that they pulled up to a loading dock, where they'd inject a radioactive tracer into my veins and then tell me not to touch my infant for 24 hours due to my slight radioactivity. I had similar restrictions after each chemo session.
The monotony of sickness-on-schedule was broken up here and there with unpleasant surprises. After my first infusion, my white blood cell count dropped so low that they had to quarantine me in my house and then skip my next chemo session to wait for my bone marrow to produce more. It would be a continuing problem, so I was always given Neulasta shots to stimulate production.
Like the MGH doctor predicted, my hair never fell out. The hair on my body thinned pleasantly, my eyebrows thinned disconcertingly, and my beard stubble was so soft that it looked effeminate. Only chemo could make a beard look effeminate. I also maintained a consistent weight throughout. Unless I told them, people didn't know I was undergoing chemotherapy.
My book debuted while I was still in treatment. With it came a season of appearances and interviews, which I scheduled around my sickness. Not once did my affliction ever come up in public. If I'd written the book after my chemotherapy rather than before it, it would probably have turned out exactly the same. Except maybe more cancer jokes.
And it makes sense to me. At no point, other than that one 45-minute car ride, was I looking death straight in its hollow eye sockets. My brush with it just wasn't bristly enough. Once it was discovered, cancer never really had a chance to kill me, and that's thanks to medical science, from the animal models to the pharmaceutical companies to the peer-reviewed research papers to the awesome oncologists and nurses. That's a pretty big buffer between me and death, and a pretty wide ray of hope for the future treatment of "extremely lethal" cancers.
Eventually, my own treatment was over. The nurses gathered around me and my wife on that last infusion session, and gave me a big send-off complete with a picture and a grade-school-style certificate of achievement. I guess I beat cancer. Or survived it. Or whatever phrase people use to inaccurately describe the process of sitting in a chair for hours while the collective expertise and knowledge from decades of research does its thing. Now, when I hear about people's cancer ordeals, I hardly feel a kinship. Mine doesn't feel like a real cancer experience. There was the sting of needles, but no sting of death.
Two years later, the biopsy scar on my neck has faded to almost invisibility. My wife's the only one that ever sees my biopsy scars. I do still have two scars on my chest, one from where they put the port in, the other from where they took it out. They're pink, parallel, and each about half an inch wide. They look like a lipstick stain and always remind me of that part of Heinlein's Stranger in a Stranger Land where Valentine Michael Smith gives the tattooed lady a kiss on the chest that miraculously imprints among the rest of her tattoos.
I still get biannual blood tests and annual PET scans, but that's mostly to monitor any ill effects of the treatment, not the disease. The last time I saw her, my oncologist used the other C word -- cured.
I still find death fascinating and weird, and I still write about it, but I consider myself on no more intimate terms with it than I was before my diagnosis.
I also still live beside St. Joseph's. Now when we pass it, I know exactly what's going on behind that distinctive first-floor arc of windows. Esme always points to the hospital and says, "That's where I was born," and I don't have anything really to add to that.